Alliance and symptom improvement in inpatient treatment for eating disorder patients: A study of within-patient processes

Int J Eat Disord. 2015 Dec;48(8):1113-21. doi: 10.1002/eat.22434. Epub 2015 Sep 5.

Abstract

Objective: This study examined the reciprocal relationship between alliance and symptoms during treatment for patients with eating disorders (ED).

Methods: Ninety one patients with EDs received inpatient cognitive-behavioral therapy treatment over 14 weeks. The study used repeated measurements during treatment and collected alliance and symptom measures. The analysis separated the effects of alliance and symptoms into between- and within-patient effects in a multilevel analysis.

Results: The results show a reciprocal relationship with between-patient alliance predicting ED symptoms and between-patient ED symptoms predicting alliance the subsequent weeks. However, for within-patient effects only alliance predicted ED symptoms the subsequent week.

Discussion: The results nuance the effect of the alliance in this patient group, and paint a complex picture of alliance in the psychotherapy process.

Keywords: alliance; eating disorder; inpatient; process research.

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Cooperative Behavior*
  • Feeding and Eating Disorders / psychology
  • Feeding and Eating Disorders / therapy*
  • Female
  • Group Processes*
  • Hospitalization
  • Humans
  • Inpatients / psychology*
  • Male
  • Middle Aged
  • Psychotherapeutic Processes
  • Research Design
  • Treatment Outcome